NSDUH Focus Group NSDUH Focus Group Moderator's Guide

NSDUH Lead Letter Focus Groups

Moderator’s Guide

August 17, 2023

Date:

Moderator:

Note taker:

Group / Location Number of Participants

Region 1 Northeast [ ]

Region 2 Midwest [ ]

Region 3 South [ ]

Region 4 West [ ]

Puerto Rico [ ]

MODERATOR: THIS IS A GUIDE TO HELP YOU LEAD THE DISCUSSION. YOU CAN MODIFY AND ADAPT THESE QUESTIONS TO MEET SITUATIONAL NEEDS DURING EACH SESSION.

SECTION I: INFORMED CONSENT (5 minutes)

INTRODUCTION OF SELF: Hello and thank you for attending this group discussion. My name is [NAME] with RTI International, a nonprofit research organization based in Research Triangle Park, North Carolina. This is my colleague [NOTE TAKER’S NAME] also with RTI. [IF OBSERVERS]: We are also joined by [an observer/observers] from our project team.

We are working on improving the materials used for a large drug and health study called the National Survey on Drug Use and Health or NSDUH.

Before we start, I would like you to read over the consent form. We sent this to you with the confirmation email. This consent form provides an overview of this research study and information about your rights as a participant. Once you are done reading the consent form, I will cover the key points, then ask each of you to confirm that you would like to participate in this discussion. If you have any questions about the consent form, please do not hesitate to ask me.

ALLOW PARTICIPANTS TIME TO REVIEW THE INFORMED CONSENT

Let me provide a summary of the key points:

• Your participation in this focus group is voluntary and you can end your participation at any time.

• Comments from all participants will be combined in a summary report and will not identify any individual.

• This focus group will take about an hour.

• We will be recording this session, to assist in preparing our summary report.

• We will provide a $75 gift card, as a token of appreciation, following this group discussion.

Any questions?

ANSWER ANY QUESTIONS THEY HAVE.

I would like to ask each of you if you agree to participate in this focus group and to be recorded.

IF ANY PARTICIPANTS REFUSE TO PARTICIPATE AND/OR BE RECORDED, NOTETAKER SHOULD PRIVATELY THANK THEM AND POLITELY REMOVE THEM FROM THE SESSION.

SECTION II: INTRODUCTION (5 minutes)

This group discussion is in support of an ongoing study that collects data on drugs, health, and health related behaviors. We want to improve the introductory letter that is mailed to people such as yourself to inform them about the study. I will be sharing some materials with you and asking questions to guide the discussion.

We just have a few ground rules for our discussion:

• Most importantly, there are no right or wrong answers to the questions I will be asking. Everyone’s input is equally important and helpful. We are interested in all your ideas, comments, and suggestions. It is OK to disagree with what someone says, but we ask that you do so respectfully.

• We will be recording the session and will have a note taker so we don’t miss anything that is said, but we will not link comments with anyone personally. We will only use first names during this discussion and won’t ask questions that would identify someone. The recording will be destroyed when we have completed the summary report.

• We ask that everyone have their cameras turned on. This will make it easier for you to know when you can add a comment without talking over one-another.

• Only one person should speak at a time. This serves two purposes. First, it makes sure the whole group hears their remarks. Second, it ensures the recording will be clear.

• To get the best benefit, we want to hear from everyone. Like any group, some of you might be more or less talkative in group settings. If I haven’t heard from you, I may call on you. This allows us to hear from everyone a few times by the end of the session. If you’d rather not answer a particular question, you can just tell me that you would like to “pass.”

• If you need to take a short break, please let us know by entering a comment in the chat window. Does everyone see where the chat feature is located?

• At the end of the session, we will send each of you a $75 gift card as a token of our appreciation for participating in today’s discussion.

Are there any questions or comments? [ANSWER ANY QUESTIONS AT THIS POINT]

Before we begin, let’s introduce ourselves. Please provide your first name and where you are from. [CALL ON PARTICIPANTS TO INTRODUCE THEMSELVES]

ENSURE EVERYONE (INCLUDING YOU AND NOTETAKER) HAS INTRODUCED THEMSELVES.

BEGIN RECORDING.

SECTION III: PARTICIPATION IN SURVEYS (10 minutes)

I wanted to start out with a few questions regarding participation in surveys.

1. Have any of you completed a survey in the past?

1. Was this a survey conducted by a private company, college or university or sponsored by a government agency?

2. What motivated you to take part in the survey?

3. What are some reasons you would not take part in a survey?

4. [IF PRIVACY AND/OR CONFIDENTIALITY NOT MENTIONED] Would you have any concerns about the privacy of the information you provide?

1. [IF YES] What would convince you that your data is being protected and confidentiality assured?

SECTION IV: LEAD LETTER A (15 minutes)

Thanks. Let’s move on to reviewing the two letters that we have provided to you. These were attached to the confirmation and reminder emails. Please confirm when you have them available to review. We will review one letter at a time. For now, just confirm that you have access to the two letters we sent you.

[ENSURE ALL PARTICIPANTS HAVE THE LEAD LETTERS]

As I mentioned earlier, these letters are for an ongoing study that collects data on drugs, health, and health related behaviors. We have two different versions of the letter that households selected for the study might receive. The letter would be mailed to your home in custom white #10 windowed envelope with the Department of Health and Human Services and logo printed on the top left corner, along with RTI’s return address. The letter would be addressed to “resident,” and this is likely to be the first time you would become aware of the study.

Let’s take a look at the first letter. Please open the attachment for: “LETTER A” – I will also display the letter onscreen.

[INTERVIEWER - DISPLAY LETTER A]

The letter will be printed with English on the front and Spanish on the back, but you can see both versions by scrolling down. There are no substantial differences between these letters other than one is in English and the other in Spanish.

[ASK BEFORE PARTICIPANTS READ THE LETTER] Before reading the letter, from your first impression, do you think you would be likely to read this letter if you received it in the mail? Why or why not?

Please take a few minutes to read over the letter.

[PROVIDE PARTICIPANTS A FEW MINUTES TO READ LETTER]

A. I am interested in your initial reactions to the content of the letter, graphics, and layout:

1. What are some of the first things you noticed about the content of the letter?

1. How about the graphics, including logo, header and QR (that is, quick response) code? What are your impressions of these features?

2. Would you have any concerns about using a QR code if provided in this letter?

1. [IF YES] What concerns would you have?

3. How likely would you be to scan a QR code if provided to you? Why might you not want to use a QR code?

4. What are your thoughts regarding how the information is presented?

5. Do you think having the Department of Health and Human Services header and logo would make you likely to read the letter? Why or why not?

2. Is there anything about the information provided in the letter that would make you concerned about completing the survey?

1. The letter explains that NSDUH collects data on, “…the use and nonuse of alcohol, tobacco and other substances, as well as mental health and other health-related topics.” – What are your thoughts after reading that statement?

3. How likely or unlikely would you be to visit the website link provided in the letter?

ASK THE FOLLOWING QUESTIONS ONLY IF THESE POINTS WERE NOT ALREADY MENTIONED IN THE DISCUSSION:

4. The letter is signed by two people, one from the sponsoring federal agency (SAMHSA) and one from the survey organization (RTI). What impression do the two signatures give you about the survey?

5. The letter includes the name of the survey, the National Survey on Drug Use and Health. Do you think knowing the name would make you more or less likely to participate?

SECTION V: LEAD LETTER B (15 minutes)

Let’s now take a look at another version of the letter. Please open the attachment for: “LETTER B” – I will also display the letter on screen. As with the first letter, English will be printed on the front with Spanish on the back.

[INTERVIEWER - DISPLAY LETTER B]

[ASK BEFORE PARTICIPANTS READ THE LETTER] Before reading the letter, from your first impression, do you think you would be likely to read this letter if you received it in the mail? Why or why not?

Please take a few minutes to read over the letter.

[PROVIDE PARTICIPANTS A FEW MINUTES TO READ LETTER]

A. I am interested in your initial reactions to the content of the letter, graphics, and layout:

1. What are some of the first things you noticed about the content of this letter?

1. How about the graphics, including logo, header and QR code? What are your impressions of these features?

2. What are your thoughts regarding how the information is presented - for example, the inclusion of a box around the online participation instructions?

• How about the section for privacy information and ways to contact us?

2. Is there information that you would like to know about the survey, but is not included in the letter?

3. Is there anything about the information that is provided that would concern you about completing the survey?

4. How likely or unlikely would you be to visit the website link or call the toll-free number provided in the letter?

SECTION VI: LETTER COMPARISON (10 minutes)

Thank you – The information you have provided so far is very helpful. I now would like to talk about both letters collectively.

Please open the attachment for: “Combined letters - C” – I will also display the letters on screen.

[INTERVIEWER - DISPLAY COMBINED LETTERS C]

This is a side-by-side comparison of both letters that we just reviewed.

1. After reading through and discussing both letters, I want to ask each of you, which letter do you prefer and why? Let’s start with [NAME]?

2. After seeing both letters, do you prefer a version with more information and details about the survey or less information?

3. Are there any other similarities or differences between the two versions of the letters that you noticed?

1. Letter B includes a statement: “Your participation is voluntary but important for shaping the future of our nation's health services.”, while Letter A states, “Your participation in this study is voluntary but important to the nation.”

– Did you notice the difference when reading the letters?

– What are your thoughts after reading this statement? Do you prefer one over the other?

4. Is there anything included in Letter A that you suggest be included in Letter B?

5. Which letter looks:

– more professional to you? Why?

– more official to you? Why?

6. Do you think you would share the letter you received or information in the letter with anyone in your household?

ASK THE FOLLOWING QUESTIONS ONLY IF THESE POINTS WERE NOT ALREADY MENTIONED IN THE DISCUSSION:

7. Both letters explain that an adult member of the household should click on a URL or scan the QR code if interested in participating. This would open a short screening instrument to determine eligibility to participate in the survey.

Was anything confusing about this request to complete a screening as opposed to the full survey? Please explain.

Would you expect to receive the $30 after answering these initial questions?

[IF CONFUSING]: What information could we provide here to clarify our request to have interested participants complete the initial screener?

8. Both letters indicate that if someone in the household is selected and completes the full interview, they will receive $30. Would this make you more or less likely to complete the survey?

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SECTION VII: CONCLUSION (5 minutes)

1. Overall, if either of these letters were sent to your home, do you think you would participate in the survey?
   
   

2. What factors noted in the letters would most influence whether or not you would participate?

3. Is there other information you would like to have about the survey before deciding to participate?

4. Do you have any final comments that would help us improve either letter?

I want to thank you all for your participation. As mentioned, we will send you a $75 gift card for your time.

TURN OFF THE RECORDING.

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